Basic Information
| Provider Information | |||||||||
| NPI: | 1639235153 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MATTHEWS | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | L.P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 JACKSON ST | ||||||||
| Address2: | |||||||||
| City: | GLENSHAW | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151161417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124875469 | ||||||||
| FaxNumber: | 4126611304 | ||||||||
| Practice Location | |||||||||
| Address1: | 6324 MARCHAND ST | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152064312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126611239 | ||||||||
| FaxNumber: | 4126611304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | PC001968 | PA | Y | Agencies | Community/Behavioral Health |
No ID Information.